Scientific Evidence

At ASW, we believe complete healing requires active participation on your part and in most cases includes gentle soft tissue mobilization techniques including myofascial release, MELT Method self-care, and therapeutic exercise. This approach promotes permanent structural change, eliminating pain and other symptoms.

Research Studies Bibliograpy

This is by no means an exhaustive list. However, it is a collection of articles which can serve as a jumping off point for the inquisitive.

Back pain:

  1. Ajimsha MS, Daniel B, Chithra S. Effectiveness of Myofascial release in the management of chronic low back pain in nursing professionalsReceived: February 2, 2013; Received in revised form: April 24, 2013; Accepted: May 5, 2013; Published Online: June 07, 2013
  2. Tozzi P, Bongiorno D, Vitturini C: Fascial release effects on patients with non-specific cervical or lumbar pain. J Bodyw Mov Ther, 2011, 15: 405–416.
  3. Koes, B.W., Bouter, L.M., van Mameren, H., Essers, A.H., Verstegen, G.J., Hofhuizen, D.M., Houben, J.P., Knipschild, P.G. A randomized clinical trial of manual therapy and physiotherapy for persistent back and neck complaints: subgroup analysis and relationship between outcome measures. (May)J. Manip. Physiol. Ther. 1993;16:211–219.

Cervical spine/TMJ:

Barnes, J.F. Myofascial release for craniomandibular pain and dysfunction. (Nov)Int. J. Orofac. Myol. 1996;22:20–22.

63% chronic back pain patients have myofascial pain:

Chen CK1Nizar AJ. Myofascial pain syndrome in chronic back pain patients. Korean J Pain. 2011 Jun;24(2):100-4. doi: 10.3344/kjp.2011.24.2.100. Epub 2011 Jun 3.


LeBauer, A., Brtalik, R., Stowe, K. The effect of myofascial release (MFR) on an adult with idiopathic scoliosis. J. Bodyw. Mov. Ther. 2008;12:356–363.

Fibromyalgia: Inflammation can exist within fascia, leading to super sensitive nerves.1

  1. Liptan GL1. Fascia: A missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther.2010 Jan;14(1):3-12.Gerwin RD. A review of myofascial pain and fibromyalgia--factors that promote their persistence. Acupunct Med. Sep 2005;23(3):121-34.
  2. Alonso-Blanco C, Fernández-de-Las-Peñas C, Morales-Cabezas M, Zarco-Moreno P, Ge HY, Florez-García M. Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. Clin J Pain. Jun 2011;27(5):405-13.[Medline].


  1. Ettlin T, Schuster C, Stoffel R, Bruderlin A, Kischka U. A distinct pattern of myofascial findings in patients after whiplash injury. Arch Phys Med Rehabil. 2008;89(7):1290–1293. doi: 10.1016/j.apmr.2007.11.041.
  2. Fernandez de las Penas, C., Palomeque del Cerro, L., Carnero, J. Manual treatment of post-whiplash injury. J. Bodyw. Mov. Ther. 2005;9:109–119.


  1. Ajimsha MS1. Effectiveness of direct vs indirect technique myofascial release in the management of tension-type headache. J Bodyw Mov Ther.2011 Oct;15(4):431-5. doi: 10.1016/j.jbmt.2011.01.021. Epub 2011 Feb 11.
  1. Castien RF1van der Windt DAGrooten ADekker J. Effectiveness of manual therapy for chronic tension-type headache: a pragmatic, randomised, clinical trial. Cephalalgia. 2011 Jan;31(2):133-43. doi: 10.1177/0333102410377362. Epub 2010 Jul 20.


Hamstrings: suboccipital release using a Barnes style approach results in increased hamstring length.1,2 Rectus capitus minor muscle attaches directly to the spinal dura.3

  1. Cho S-H, Kim S-H, Park D-J. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring. Journal of Physical Therapy Science. 2015;27(1):195-197. doi:10.1589/jpts.27.195.
  2. Aparicio EQ, Quirante LB, Blanco CR, et al. : Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome. J Manipulative Physiol Ther, 2009, 32: 262–269.
  3. Hack GD, Koritzer RT, Robinson WL, et al. : Anatomic relation between the rectus capitis posterior minor muscle and the dura mater. Spine, 1995, 20: 2484–2486.
  4. Gajdosik RL, Hatcher CK, Whitsell S.: Influence of short hamstring muscles on the pelvis and lumbar spine in standing and during the toe-touch test. Clin Biomech (Bristol, Avon), 1992, 7: 38–42.
  5. Myers TW.: Anatomy trains. Edinburgh: Churchill Livingstone, 2005, pp 97–101.
  6. Kuruma H, Takei H, Nitta O, et al. : Effects of myofascial release and stretching technique on range of motion and reaction time. J Phys Ther Sci, 2013, 25: 169–171.
  7. Hanten WP: Effects of myofascial release leg pull and sagittal plane isometric contract-relax techniques on passive straight-leg raise angle. J Orthop Sports Phys Ther, 1994, 20: 138–144.


  1. Roach S, Sorenson E, Headley B, San Juan JG.

Prevalence of myofascial trigger points in the hip in patellofemoral pain.

Arch Phys Med Rehabil. 2013 Mar;94(3):522-6. doi: 10.1016/j.apmr.2012.10.022. Epub 2012 Nov 2.

  1. Myofascial pain in patients waitlisted for total knee arthroplasty.

Henry R, Cahill CM, Wood G, Hroch J, Wilson R, Cupido T, Vandenkerkhof E.

Pain Res Manag. 2012 Sep-Oct;17(5):321-7.

Lateral epicondylitis:

  1. Ajimsha MS1Chithra SThulasyammal RP. Effectiveness of myofascial release in the management of lateral epicondylitis in computer professionals. Arch Phys Med Rehabil.2012 Apr;93(4):604-9. doi: 10.1016/j.apmr.2011.10.012. Epub 2012 Jan 10.
  2. Shmushkevich Y, Kalichman L. Myofascial pain in lateral epicondylalgia: a review.

J Bodyw Mov Ther. 2013 Oct;17(4):434-9. doi: 10.1016/j.jbmt.2013.02.003. Epub 2013 Apr 21. Review.

Nerve pain

1.Facco E, Ceccherelli F. Myofascial pain mimicking radicular syndromes. Acta Neurochir Suppl. 2005;92:147-50.

Plantar Fasciitis

Ajimsha MS, Binsu D, Chithra S. Effectiveness of myofascial release in the management of plantar heel pain: a randomized controlled trial. Foot (Edinb). 2014 Jun;24(2):66-71. doi: 10.1016/j.foot.2014.03.005. Epub 2014 Mar 21.


30% of patients visiting MD for pain:

Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice.West J Med. 1989;151:157–160.


Bron C, Dommerholt J, Stegenga B, Wensing M, Oostendorp RA. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain. BMC Musculoskeletal Disorders. 2011;12:139. doi:10.1186/1471-2474-12-139.

Bron C, Franssen J, Wensing M, Oostendorp RA. Interrater reliability of palpation of myofascial trigger points in three shoulder muscles. J Man Manip Ther. 2007;15(4):203–215.


  1. Chan YC, Wang TJ, Chang CC, et al. Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome. J Phys Ther Sci. Jan 2015;27(1):217-21.
  2. Cho S-H, Kim S-H, Park D-J. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring. Journal of Physical Therapy Science. 2015;27(1):195-197. doi:10.1589/jpts.27.195.
  3. Sullivan KM, Silvey DB, Button DC, et al. : Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. Int J Sports Phys Ther, 2013, 8: 228–236. [PMC free article] [PubMed]
  4. Sheffield K, Cooper N.: The immediate effects of self-myofascial release on female footballers.Sportex Dyn, 2013, 38: 12–17.

Systemic sclerosis:

Martin MM: Effects of myofascial release in diffuse systemic sclerosis. J Bodyw Mov Ther, 2009, 13: 320–327.


Castelli L1De Santis FDe Giorgi IDeregibus ATesio VLeombruni PGranieri ADebernardi CTorta R. Alexithymia, anger and psychological distress in patients with myofascial pain: a case-control study. Front Psychol. 2013 Jul 31;4:490. doi: 10.3389/fpsyg.2013.00490. eCollection 2013.

Reaction time increases with myofascial release.1

  1. Kuruma H, Takei H, Nitta O, et al. : Effects of myofascial release and stretching technique on range of motion and reaction time. J Phys Ther Sci, 2013, 25: 169–171.

Women’s Health:

Lukban, J. The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac dysfunction. Urology. 2001;57:121.


  1. Walton, A.Efficacy of myofascial release techniques in the treatment of primary Raynaud’s phenomenon. (Jul) Bodyw. Mov. Ther. 2008;12:274–280 (Epub 2008 Mar 5).
  2. Dunn, M.G., Silver, F.H. Viscoelastic behavior of human connective tissue: relative contribution of viscous and elastic components. Connect. Tissue Res. 1983;12:59–70.
  3. Sasaki, N., Odajima, S. Elongation mechanism of collagen fibrils and force-strain relations of tendon at each level of structural hierarchy. J. Biomech. 1996;29:1131–1136.
  4. Ingber, D.E., Chen, C.S. Tensegrity and mechanoregulation: from skeleton to cytoskeleton. J. Osteoarthr. Res. Soc. Int. 1999;7:81–94.
  5. Karabay, N., Toros, T., Hurel, C. Ultrasonographic evaluation in plantar fasciitis. (Nov-Dec)J. Foot Ankle Surg.2007;46:442–446.
  6. Kenney, A.H., Hafner, J.N. Ultrasonic evidence of inflammatory thickening and fluid collection within the retrobulbar fascia: the T sign. (Dec)Ann. Ophthalmol. 1977;9:1557–1563.
  7. Langevin, H. Connective tissue: a body-wide signaling network?. Medical Hypotheses. 2006;66:1074–1077.
  8. Lund, I., Ge, Y., Yu, L.C. et al, Repeated massage-like stimulation induces long-term effects on nociception: contribution of oxytocinergic mechanisms. Eur. J. Neurosci. 2002;16:330–338.
  9. Mosler, E., Folkhard, W., Knorzer, E., Nemetschek-Gansler, H., Nemetschek, T.H., Koch, M.H. Stress-induced molecular arrangement in tendon collagen. J. Mol. Biol. 1985;182:589–596.
  10. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points.Arch Phys Med Rehabil. Jul 1998;79(7):863-72. [Medline]
  11. Annaswamy TM, DeLuigi AJ, O’Neill BJ, et al. Emerging Concepts in the Treatment of Myofascial Pain: A Review of Medications, Modalities, and Needle-based Interventions. PM R volume 3, issue 10 (October, 2011), p. 940-961.Fogelman Y, Kent J. Efficacy of dry needling for treatment of myofascial pain syndrome. J Back Musculoskelet Rehabil. 2014 Oct 15
  12. Fernández de las Peñas C, Cuadrado ML, Arendt-Nielsen L, Simons DG, Pareja JA. Myofascial trigger points and sensitisation: an updated pain model for tension type headache. Cephalalgia 2007;27:383–93.
  13. Tough EA, White AR, Cummings TM, Richards SH, Campbell JL. Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Eur J Pain 2009;13:3–10.
  14. Dorsher PT. Myofascial referred-pain data provide physiologic evidence of acupuncture meridians. J Pain. Jul 2009;10(7):723-31.


Key terms in pubmed:

Chronic myofascial pain

Myofascial syndrome